1.Clinical study on vertebroplasty combined with zoledronic acid for osteoporotic thoracolumbar vertebral compression fractures
Chengmin MO ; Lajia CAI ; Jianxiong LIN
Chinese Journal of Primary Medicine and Pharmacy 2015;(5):666-669,670
Objective To observe the clinical effects and safety of vertebroplasty combined with zoledronic acid for osteoporotic thoracolumbar vertebral compression fractures .Methods 56 osteoporotic thoracolumbar vertebral compression fractures patients were radomly divided into the two groups ,each group had 28 cases.All patients had re-set treatment including lying on the hard bed and Padded waist .The treatment group had the surgery of vertebroplasty , 3 days after surgery these patients treated with 100mL Zoledronic acid by means of intravenous drip .The control group had the conservative treatment ,these patients received the closed reduction ,after operations the patients had the treat-ment of traction suspension ,lying on the hard bed ,padded the fractures .The two groups were compared at the time be-fore treatment,24h after treatment and 6 months after treatment .The anterior height of vertebral body ,kyphosis Cobb's
angle,low back pain visual analog scale ,Oswsetry dysfunction index score and complications were included into the study.Results (1) The anterior height of vertebral body: The difference of the anterior height of vertebral body at different time before or after the treatment was statistically significant , that showed the time effect [ the treatment group:(13.81 ±2.09)mm,(20.14 ±2.26)mm,(21.89 ±2.60mm;the control group:(15.24 ±2.21)mm,(17.39 ± 2.57)mm,(17.40 ±1.81) mm].The difference of the overall anterior height of vertebral body between the two groups was statistically significant ,which showed the grouping effect .(2) Kyphosis Cobb's angle: The difference of Kyphosis Cobb's angle at different time was statistically significant ,which showed the time effect [ the treatment group:(26.18 ±2.03)°,(9.56 ±1.11)°,(9.57 ±1.08)°;the control group:(27.36 ±2.71)°,(14.59 ±1.28)°, (14.52 ±1.48)°],the difference of the overall Kyphosis Cobb's angle between the two groups was statistically signifi-cant,which showed the grouping effect .(3) Low back pain visual analog scale:The difference of low back pain visual analog scale at different time was statistically significant ,which showed the time effect[the treatment group:(8.31 ± 0.94)points,(1.86 ±0.74) points,(1.87 ±0.77) points;the control group:(8.12 ±0.95) points,(3.85 ± 1.07)points,(3.82 ±1.08)points].The difference of the overall low back pain visual analog scale between the two groups was statistically significant , which showed the grouping effect .( 4 ) Oswsetry dysfunction index score: The difference of Oswsetry dysfunction index score at different time was statistically significant , which showed the time effect[the treatment group:(73.27 ±4.55)points,(32.11 ±2.57)points,(29.14 ±3.60)points;the control group:(75.49 ±4.20)points,(43.83 ±2.98)points,(38.67 ±5.28)points].The difference of the overall Oswsetry dys-function index score between the two groups was statistically significant ,which showed the grouping effect .Conclusion The treatment of vertebroplasty combined with zoledronic acid for osteoporotic thoracolumbar vertebral compression fractures was effective .It is able to relieve low back pain ,improve bone density and quality ,improve life quality ,and prevent Osteoporosis from further development .
2.Mycophenolate mofetil combined with low dose of hormone and lamivudine in the treatment of hepatitis B virus associated glomerulonephritis
Chengmin CAI ; Lin WEI ; Zhixin DUAN ; Wei WU ; Haitao ZONG
Chinese Journal of Postgraduates of Medicine 2011;34(31):1-4
Objective To assess the efficacy of mycophenolate mofetil (MMF) combined with low dose of hormone and lamivudine in the treatment of hepatitis B virus associated glomerulonephritis (HBV-GN).Methods The clinical data of 49 HBV-GN patients diagnosed by renal pathology was reviewed.They were treated with MMF( ≥ 12 years old,0.75 g,two times a day; < 12 years old,0.4 g/m2,two times a day),low dose of hormone [0.5 mg/(kg·d) ],lamivudine( ≥ 12 years old,100 mg/d; < 12 years old,3 mg/kg,two times a day).Results Among of 49 HBV-GN patients,clinical cure rate was 71.4%(35/49),the total effective rate was 81.6%(40/49),85.7%(42/49) patients' HBV DNA level decreased from 5.43 ×104 copies/ml to < 1000 copies/ml.The complete remission rate was 88.0% (22/25),the partial remission rate was 8.0% (2/25),the inefficiency was 4.0% (1/25) in membranous nephropathy (MN);the complete remission rate was 44.4% (4/9),the inefficiency was 55.6% (5/9) in mesangial proliferative glomerulone phritis (MsPGN) ; the complete remission rate was 70.0%(7/10); the partial remission rate was 30.0%(3/10)in membrane proliferative glomerulone phritis (MPGN) ;the complete remission rate was 40.0% (2/5),the inefficiency was 60.0%(3/5) in focal segmental glomerulosclerosts (FSGS).There was significant difference among the different pathological type (P<0.05).There were less adverse reactions.Conclusions MMF combined with low dose hormone and lamivudine is safe and effective in treating HBV-GN.The efficacy and pathological type has some relationship,MN has the best response,MPGN and MsPGN are second,FSGS is poor.
3.Expression and significance of asymmetric dimethylarginine in fetal growth restriction
Qiuling CHEN ; Houlin ZENG ; Min CAI ; Lan YAO ; Xiaohong YANG ; Chengmin LI
Journal of Chinese Physician 2015;17(12):1813-1815,1819
Objective To investigate the serum and placental expressions of asymmetric dimethylarginine (ADMA) and nitric oxide(NO) in fetal growth restriction (FGR),and explore the biological role and mechanisms of ADMA in FGR.Methods Fifty patients with FGR (FGR group)and 50 normal term pregnant women (control group) were detected for the levels of ADMA in maternal sera and placentas with enzyme linked immunosorbent assay (ELISA).The level of NO in maternal sera was analyzed with nitrate reductase method,and the placental tissue sections were analyzed with pathological morphologly.Results For FGR group,the main pathological changes were growth retardation of villi,increased syncytiotrophoblast nodules,and the lack terminal villi;and the incidence rate of pathological change of placental tissue was significantly higher than that in control group [64.0% (32/50) vs 12.0% (6/50),x2 =7.90,P < 0.01].For the placental pathological change group,the concentrations of ADMA in the placentas and sera were significantly higher than the normal group [placenta ADMA:(2.21 ± 0.72) μmol/L vs (1.69 ± 0.77) μmol/L,t =3.33,P < 0.01;serum ADMA:(2.01 ± 0.70) μmoL/L vs (1.18 ± 0.54) μmol/L,t =6.66,P <0.01].The expression of ADMA was up-regulated in maternal sera and placentas from FGR group compared to normal pregnancy [placenta ADMA (2.24 ± 0.81) μmol/L vs (1.53 ± 0.59) μmol/L,t =5.00,P <0.01;serum ADMA (1.89 ±0.75) μmol/L vs (1.10 ±0.43) μ mol/L,t =6.45,P < 0.O1].The NO was extremely lower expressed in maternal sera with FGR than normal pregnancy [(39.59 ± 9.15) μmol/L vs (58.02 ± 15.45) μmol/L t =-7.26,P < 0.01)].For FGR group,a significant negative correlation was observed between ADMA and NO expressions in sera (r =-0.693,P < 0.01).Conelusions ADMA was associated with the occurrence and development of the FGR,and its mechanism maybe inhibits NO synthesis to result in placental malperfusion.